are Thousands more patients with type 1 diabetes are getting flash glucose devices, data show By feeds.bmj.com Published On :: Monday, October 7, 2019 - 12:46 Full Article
are Diabetes technology: specialists are blocking access for some patients, say experts By feeds.bmj.com Published On :: Thursday, October 17, 2019 - 13:05 Full Article
are Partha Kar: What will the 2020s hold for diabetes care? By feeds.bmj.com Published On :: Tuesday, January 21, 2020 - 14:51 Full Article
are Top 10 moments in Frank Robinson's career By mlb.mlb.com Published On :: Thu, 7 Feb 2019 16:09:25 EDT Few figures in baseball history have accomplished as much as Frank Robinson. A feared slugger, a World Series champion, a pioneer for minority managers and an ambassador for the game, Robinson had an impact that can be felt in all corners of the sport. Full Article
are Still not prepared for COVID-19 By jamaica-gleaner.com Published On :: Tue, 05 May 2020 00:09:52 -0500 THE EDITOR, Madam: How many more will have to suffer? How many more will have to die to end the discrimination often meted out to persons suspected of or confirmed with COVID-19? The novel coronavirus is highly contagious, seems so mysterious, and... Full Article
are Human conflict and ecosystem services: finding the environmental price of warfare By feedproxy.google.com Published On :: Wed, 02 Jul 2014 10:57:18 +0000 2 July 2014 , Volume 90, Number 4 Robert A. Francis and Krishna Krishnamurthy Full Article
are The Elements of Power: Gadgets, Guns and the Struggle for a Sustainable Future in the Rare Metal Age By feedproxy.google.com Published On :: Fri, 29 Apr 2016 14:30:01 +0000 Invitation Only Research Event 19 May 2016 - 5:00pm to 6:30pm Chatham House, London, UK At this session, the speaker will argue that our future hinges on a set of elements that receive scant attention even from those whose fortunes rely upon them. The speaker will outline why our electronic gadgets, the most powerful armies and indeed the fate of our planet depend on producing sustainable supplies of rare metals. He will outline some of the new environmental, economic, and geopolitical consequences of supply chains and discuss the dynamics of the rare metal markets which are vastly different than traditional commodities traded on open exchanges. The speaker will also address some of the security of supply issues arising from China's role as the dominant consumer and producer of most of the world’s minor metals. Finally, the discussion will also include what countries and companies can do to ensure resilient supply lines.Attendance at this event is by invitation only. Department/project Energy, Environment and Resources Programme Owen Grafham Manager, Energy, Environment and Resources Programme +44 (0)20 7957 5708 Email Full Article
are Inbox: Are D-backs in a rebuild year? By mlb.mlb.com Published On :: Fri, 1 Feb 2019 10:00:00 EDT Hi Steve, wondering if this is a rebuild year? Full Article
are Covid-19: Trump says added deaths are necessary price for reopening US businesses By feeds.bmj.com Published On :: 2020-05-07T07:10:42-07:00 A rise in mortality is a price worth paying to restart the US economy, President Trump has said, as many states flout advice from scientists and reopen beaches, cinemas, or hair salons while new... Full Article
are Covid-19: Health needs of sex workers are being sidelined, warn agencies By feeds.bmj.com Published On :: 2020-05-07T08:46:13-07:00 Agencies have criticised the lack of action to protect the health needs of sex workers during the pandemic, with the English Collective of Prostitutes (ECP) warning of a “ticking time bomb of health... Full Article
are Comparison of 3 Interpretation Criteria for 68Ga-PSMA11 PET Based on Inter- and Intrareader Agreement By jnm.snmjournals.org Published On :: 2020-04-01T06:00:28-07:00 PET using radiolabeled prostate-specific membrane antigen (PSMA) is now being more widely adopted as a valuable tool to evaluate patients with prostate cancer (PC). Recently, 3 different criteria for interpretation of PSMA PET were published: the European Association of Nuclear Medicine (EANM) criteria, the Prostate Cancer Molecular Imaging Standardized Evaluation criteria, and the PSMA Reporting and Data System. We compared these 3 criteria in terms of interreader, intrareader, and intercriteria agreement. Methods: Data from 104 patients prospectively enrolled in research protocols at our institution were retrospectively reviewed. The cohort consisted of 2 groups: 47 patients (mean age, 64.2 y old) who underwent Glu-NH-CO-NH-Lys-(Ahx)-[68Ga(HBED-CC)] (68Ga-PSMA11) PET/MRI for initial staging of biopsy-proven intermediate- or high-risk PC, and 57 patients (mean age, 70.5 y old) who underwent 68Ga-PSMA11 PET/CT because of biochemically recurrent PC. Three nuclear medicine physicians independently evaluated all 68Ga-PSMA11 PET/MRI and PET/CT studies according to the 3 interpretation criteria. Two of them reevaluated all studies 6 mo later in the same manner and masked to the initial reading. The Gwet agreement coefficient was calculated to evaluate interreader, intrareader, and intercriteria agreement based on the following sites: local lesion (primary tumor or prostate bed after radical prostatectomy), lymph node metastases, and other metastases. Results: In the PET/MRI group, interreader, intrareader, and intercriteria agreement ranged from substantial to almost perfect for any site according to all 3 criteria. In the PET/CT group, interreader agreement ranged from substantial to almost perfect except for judgment of distant metastases based on the PSMA Reporting and Data System (Gwet agreement coefficient, 0.57; moderate agreement), in which the most frequent cause of disagreement was lung nodules. Intrareader agreement ranged from substantial to almost perfect for any site according to all 3 criteria. Intercriteria agreement for each site was also substantial to almost perfect. Conclusion: Although the 3 published criteria have good interreader and intrareader reproducibility in evaluating 68Ga-PSMA11 PET, there are some factors causing interreader disagreement. Further work is needed to address this issue. Full Article
are Evidence of Tissue Repair in Human Donor Pancreas After Prolonged Duration of Stay in Intensive Care By diabetes.diabetesjournals.org Published On :: 2020-02-20T11:55:30-08:00 M2 macrophages play an important role in tissue repair and regeneration. They have also been found to modulate β-cell replication in mouse models of pancreatic injury and disease. We previously reported that β-cell replication is strongly increased in a subgroup of human organ donors characterized by prolonged duration of stay in an intensive care unit (ICU) and increased number of leukocytes in the pancreatic tissue. In the present study we investigated the relationship between duration of stay in the ICU, M2 macrophages, vascularization, and pancreatic cell replication. Pancreatic organs from 50 donors without diabetes with different durations of stay in the ICU were analyzed by immunostaining and digital image analysis. The number of CD68+CD206+ M2 macrophages increased three- to sixfold from ≥6 days’ duration of stay in the ICU onwards. This was accompanied by a threefold increased vascular density and a four- to ninefold increase in pancreatic cells positive for the replication marker Ki67. A strong correlation was observed between the number of M2 macrophages and β-cell replication. These results show that a prolonged duration of stay in the ICU is associated with an increased M2 macrophage number, increased vascular density, and an overall increase in replication of all pancreatic cell types. Our data show evidence of marked levels of tissue repair in the human donor pancreas. Full Article
are Manual acupuncture versus sham acupuncture and usual care for prophylaxis of episodic migraine without aura: multicentre, randomised clinical trial By feeds.bmj.com Published On :: Wednesday, March 25, 2020 - 22:31 Full Article
are Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis By feeds.bmj.com Published On :: Tuesday, May 5, 2020 - 12:46 Full Article
are FTC puts Total gas market share at 30% - Sees no threat to competition from Epping deal By jamaica-gleaner.com Published On :: Fri, 08 May 2020 00:08:14 -0500 THE ACQUISITION of Epping resulted in Total Jamaica controlling nearly a third of the retail gasolene market, but that’s not enough to lessen competition, the Fair Trading Commission, FTC, has found. “The acquisition is unlikely to have either the... Full Article
are Breaking the Habit: Why Major Oil Companies Are Not ‘Paris-Aligned’ By feedproxy.google.com Published On :: Mon, 07 Oct 2019 14:50:01 +0000 Invitation Only Research Event 23 October 2019 - 8:30am to 10:00am Chatham House | 10 St James's Square | London | SW1Y 4LE Event participants Andrew Grant, Carbon Tracker InitiativeChair: Siân Bradley, Research Fellow, Energy, Environment and Resources, Chatham House The investment community is increasingly seeking to assess the alignment of their portfolios with the Paris Agreement. In a recent update to their Two Degrees of Separation report, Carbon Tracker assessed the capital expenditure of listed oil and gas producers against ‘well below’ 2C targets, and for the first time, against short-term actions at the project level.The speaker will present the key findings of the report and will argue that every oil major is betting heavily against a low-carbon world by investing in projects that are contrary to the Paris goals.This roundtable discussion will further explore the report findings and consider what investors, regulators and oil and gas companies can do to encourage alignment with the Paris Agreement ahead of 2020. Attendance at this event is by invitation only. Event attributes Chatham House Rule Department/project Energy, Environment and Resources Programme Full Article
are Climate Change, Energy Transition, and the Extractive Industries Transparency Initiative (EITI) By feedproxy.google.com Published On :: Thu, 05 Dec 2019 15:45:01 +0000 Invitation Only Research Event 17 January 2020 - 9:30am to 5:00pm Chatham House | 10 St James's Square | London | SW1Y 4LE Climate change and energy transition are re-shaping the extractive sectors, and the opportunities and risks they present for governments, companies and civil society. As the central governance standard in the extractives sector, the EITI has a critical role in supporting transparency in producer countries.This workshop will bring together experts from the energy and extractives sectors, governance and transparency, and climate risk and financial disclosure initiatives to discuss the role of governance and transparency through the transition. It will consider the appropriate role for the EITI and potential entry points for policy and practice, and the potential for coordination with related transparency and disclosure initiatives. Please note attendance is by invitation only. Department/project Energy, Environment and Resources Programme Full Article
are Why an Inclusive Circular Economy is Needed to Prepare for Future Global Crises By feedproxy.google.com Published On :: Wed, 15 Apr 2020 13:23:01 +0000 15 April 2020 Patrick Schröder Senior Research Fellow, Energy, Environment and Resources Programme @patricks_CH Google Scholar The risks associated with existing production and consumption systems have been harshly exposed amid the current global health crisis but an inclusive circular economy could ensure both short-term and long-term resilience for future challenges. 2020-04-15-Waste-Collection-Peru.jpg Lima city employees picking up garbage during lockdown measures in Peru amid the COVID-19 crisis. Photo: Getty Images. The world is currently witnessing how vulnerable existing production and consumption systems are, with the current global health crisis harshly exposing the magnitude of the risks associated with the global economy in its current form, grounded, as it is, in a linear system that uses a ‘take–make–throw away’ approach.These ‘linear risks’ associated with the existing global supply chain system are extremely high for national economies overly dependent on natural resource extraction and exports of commodities like minerals and metals. Equally vulnerable are countries with large manufacturing sectors of ready-made garments and non-repairable consumer goods for western markets. Furthermore, workers and communities working in these sectors are vulnerable to these changes as a result of disruptive technologies and reduced demand.In a recently published Chatham House research paper, ‘Promoting a Just Transition to an Inclusive Circular Economy’, we highlight why a circular economy approach presents the world with a solution to old and new global risks – from marine plastic pollution to climate change and resource scarcity.Taking the long viewSo far, action to transition to a circular economy has been slow compared to the current crisis which has mobilized rapid global action. For proponents of transitioning to a circular economy, this requires taking the long view. The pandemic has shown us that global emergencies can fast-forward processes that otherwise might take years, even decades, to play out or reverse achievements which have taken years to accomplish.In this vein, there are three striking points of convergence between the COVID-19 pandemic and the need to transition to an inclusive circular economy.Firstly, the current crisis is a stark reminder that the circular economy is not only necessary to ensure long-term resource security but also short-term supplies of important materials. In many cities across the US, the UK and Europe, councils have suspended recycling to focus on essential waste collection services. The UK Recycling Association, for example, has warned about carboard shortages due to disrupted recycling operations with possible shortages for food and medicine packaging on the horizon.Similarly, in China, most recycling sites were shut during the country’s lockdown presenting implications for global recycling markets with additional concerns that there will be a fibre shortage across Europe and possibly around the world.Furthermore, worldwide COVID-19 lockdowns are resulting in a resurgence in the use of single-use packaging creating a new wave of plastic waste especially from food deliveries – already seen in China – with illegal waste fly-tipping dramatically increasing in the UK since the lockdown.In this vein, concerns over the current global health crisis is reversing previous positive trends where many cities had established recycling schemes and companies and consumers had switched to reusable alternatives.Secondly, the need to improve the working conditions of the people working in the informal circular economy, such as waste pickers and recyclers, is imperative. Many waste materials and recyclables that are being handled and collected may be contaminated as a result of being mixed with medical waste.Now, more than ever, key workers in waste management, collection and recycling require personal protective equipment and social protection to ensure their safety as well as the continuation of essential waste collection so as not to increase the potential for new risks associated with additional infectious diseases.In India, almost 450 million workers including construction workers, street vendors and landless agricultural labourers, work in the informal sector. In the current climate, the poorest who are unable to work pose a great risk to the Indian economy which could find itself having to shut down.Moreover, many informal workers live in make-shift settlements areas such as Asia’s largest slum, Dharavi in Mumbai, where health authorities are now facing serious challenges to contain the spread of the disease. Lack of access to handwashing and sanitation facilities, however, further increase these risks but circular, decentralized solutions could make important contributions to sustainable sanitation, health and improved community resilience.Thirdly, it is anticipated that in the long term several global supply chains will be radically changed as a result of transformed demand patterns and the increase in circular practices such as urban mining for the recovery and recycling of metals or the reuse and recycling of textile fibres and localized additive manufacturing (e.g. 3D printing).Many of these supply chains and trade flows have now been already severely disrupted due to the COVID-19 pandemic. For example, the global garment industry has been particularly hard-hit due to the closure of outlets amid falling demand for apparel.It is important to note, workers at the bottom of these garment supply chains are among the most vulnerable and most affected by the crisis as global fashion brands, for example, have been cancelling orders – in the order of $6 billion in the case of Bangladesh alone. Only after intense negotiations are some brands assuming financial responsibility in the form of compensation wage funds to help suppliers in Myanmar, Cambodia and Bangladesh to pay workers during the ongoing crisis.In addition, the current pandemic is damaging demand for raw materials thereby affecting mining countries. Demand for Africa’s commodities in China, for example, has declined significantly, with the impact on African economies expected to be serious, with 15 per cent of the world’s copper and 20 per cent of the world’s zinc mines currently going offline. A further threat is expected to come from falling commodity prices as a result of the curtailment of manufacturing activity in China particularly for crude oil, copper, iron ore and other industrial commodities which, in these cases, will have direct impacts on the Australian and Canadian mining sectors.This is all being compounded by an associated decline in consumer demand worldwide. For example, many South African mining companies – leading producers of metals and minerals – have started closing their mining operations following the government’s announcement of a lockdown in order to prevent the transmission of the virus among miners who often work in confined spaces and in close proximity with one another. As workers are laid off due to COVID-19, there are indications that the mining industry will see fast-tracking towards automated mining operations. All of these linear risks that have been exposed through the COVID-19 pandemic reinforce the need for a just transition to a circular economy. But while the reduction in the consumption of resources is necessary to achieve sustainability, the social impacts on low- and middle- income countries and their workers requires international support mechanisms.In addition, the current situation also highlights the need to find a new approach to globalized retail chains and a balance between local and global trade based on international cooperation across global value chains rather than implementation of trade protectionist measures.In this vein, all of the recovery plans from the global COVID-19 pandemic need to be aligned with the principles of an inclusive circular economy in order to ensure both short-term and long-term resilience and preparedness for future challenges and disruptions. Full Article
are Healthcare comes to standstill in east Aleppo as last hospitals are destroyed By feeds.bmj.com Published On :: Wednesday, November 23, 2016 - 13:46 Full Article
are Covid-19: GPs have a fortnight to start organising weekly care home reviews, says NHS By feeds.bmj.com Published On :: Tuesday, May 5, 2020 - 11:01 Full Article
are Partha Kar: Covid-19 and ethnicity—why are all our angels white? By feeds.bmj.com Published On :: Tuesday, May 5, 2020 - 11:31 Full Article
are Covid-19: UK advisory panel members are revealed after experts set up new group By feeds.bmj.com Published On :: Tuesday, May 5, 2020 - 12:31 Full Article
are Self-protection: how NHS doctors are sourcing their own PPE By feeds.bmj.com Published On :: Wednesday, May 6, 2020 - 12:25 Full Article
are Covid-19: the challenge of patient rehabilitation after intensive care By feeds.bmj.com Published On :: Wednesday, May 6, 2020 - 12:36 Full Article
are Covid-19: Woman with terminal cancer should be released from care home to die with family, says judge By feeds.bmj.com Published On :: Wednesday, May 6, 2020 - 15:01 Full Article
are Covid-19: Trump says added deaths are necessary price for reopening US businesses By feeds.bmj.com Published On :: Thursday, May 7, 2020 - 14:10 Full Article
are An Untapped Pool of Critical U.S. Health-Care Workers in a Time of Pandemic By www.migrationpolicy.org Published On :: Tue, 07 Apr 2020 11:06:18 -0400 As the U.S. health-care system sags under the strain of the COVID-19 pandemic, health-care workers are not only on the frontlines fighting the virus, they are also some of the most at-risk individuals, making it more essential than ever to have sufficient numbers of qualified health professionals. While 1.5 million immigrants and refugees are already working in the U.S. health-care system, an additional 263,000 immigrants and refugees in the U.S. with health-related college degrees are working in low-skilled jobs or are out of work. Full Article
are Children of Immigrants and Child Welfare Systems: Key Policy and Practice By www.migrationpolicy.org Published On :: Tue, 23 Apr 2019 18:33:43 -0400 Marking the release of an MPI report, this webinar examines what the growing intersection between U.S. immigration and child welfare systems means for protection agencies. Speakers also discuss promising child welfare policies and agency approaches to address the needs of children of immigrants and their families amid demographic change and rising immigration enforcement. Full Article
are A Profile of U.S. Children with Unauthorized Immigrant Parents By www.migrationpolicy.org Published On :: Mon, 11 Jan 2016 13:06:23 -0500 Growing up with unauthorized immigrant parents puts children—nearly 80 percent of whom were born in the United States—at a disadvantage, with lower preschool enrollment, reduced socioeconomic progress, and higher rates of linguistic isolation and poverty. This fact sheet examines the number, characteristics, and socioeconomic status of children, both U.S.-citizen and noncitizen, who have unauthorized immigrant parents. Full Article
are South Korea Carefully Tests the Waters on Immigration, With a Focus on Temporary Workers By www.migrationpolicy.org Published On :: Tue, 28 Feb 2017 15:00:05 -0500 Faced with labor shortages in key sectors of the economy, South Korea has moved carefully in recent decades toward accepting greater numbers of workers—albeit in temporary fashion. Its Employment Permit System, launched in 2003, earned international accolades for bringing order and legality to immigration in the country, although several challenges remain to be addressed as this Country Profile explores. Full Article
are With Engaged Parenting, "Terrible Twos" Are Not Inevitable By feeds.socialpsychology.org Published On :: 2020-05-06T09:31:52-04:00 Source: Science Daily - Top HealthParents should not feel pressured to make their young children undertake structured learning or achieve specific tasks, particularly during lockdown. A new study of children under the age of two has found that parents who take a flexible approach to their child's learning can minimize behavioral problems during toddlerhood. Full Article
are Randomized Study to Evaluate the Impact of Telemedicine Care in Patients With Type 1 Diabetes With Multiple Doses of Insulin and Suboptimal HbA1c in Andalusia (Spain): PLATEDIAN Study By care.diabetesjournals.org Published On :: 2020-01-20T12:00:30-08:00 OBJECTIVE To assess the impact of a telemedicine visit using the platform Diabetic compared with a face-to-face visit on clinical outcomes, patients’ health-related quality of life (HRQoL), and physicians’ satisfaction in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS PLATEDIAN (Telemedicine on Metabolic Control in Type 1 Diabetes Mellitus Andalusian Patients) (NCT03332472) was a multicenter, randomized, 6-month follow-up, open-label, parallel-group controlled study performed in patients with type 1 diabetes with suboptimal metabolic control (HbA1c <8% [<64 mmol/mol]), treated with multiple daily injections. A total of 388 patients were assessed for eligibility; 379 of them were randomized 1:1 to three face-to-face visits (control cohort [CC]) (n = 167) or the replacement of an intermediate face-to-face visit by a telemedicine visit using Diabetic (intervention cohort [IC]) (n = 163). The primary efficacy end point was the mean change of HbA1c levels from baseline to month 6. Other efficacy and safety end points were mean blood glucose, glucose variability, episodes of hypoglycemia and hyperglycemia, patient-reported outcomes, and physicians’ satisfaction. RESULTS At month 6, the mean change in HbA1c levels was –0.04 ± 0.5% (–0.5 ± 5.8 mmol/mol) in the CC and 0.01 ± 0.6% (0.1 ± 6.0 mmol/mol) in the IC (P = 0.4941). The number of patients who achieved HbA1c <7% (<53 mmol/mol) was 73 and 78 in the CC and IC, respectively. Significant differences were not found regarding safety end points at 6 months. Changes in HRQoL between the first visit and final visit did not differ between cohorts, and, regarding fear of hypoglycemia (FH-15 score ≥28), statistically significant differences observed at baseline remained unchanged at 6 months (P < 0.05). CONCLUSIONS The use of telemedicine in patients with type 1 diabetes with HbA1c <8% (<64 mmol/mol) provides similar efficacy and safety outcomes as face-to-face visits. Full Article
are Diabetes INSIDE: Improving Population HbA1c Testing and Targets in Primary Care With a Quality Initiative By care.diabetesjournals.org Published On :: 2020-01-20T12:00:30-08:00 OBJECTIVE To improve outcomes of patients with adult type 2 diabetes by decreasing HbA1c undertesting, reducing the proportion of patients with poor glycemic control, and lowering mean HbA1c levels using a quality improvement (QI) program. RESEARCH DESIGN AND METHODS Six years of outpatient electronic health record (EHR) data were analyzed for care gaps before and 2 years after implementing a QI initiative in an urban academic medical center. QI strategies included 1) individual provider and departmental outcome reports, 2) patient outreach programs to address timely follow-up care, 3) a patient awareness campaign to improve understanding of achieving clinical goals, 4) improving EHR data capture to improve population monitoring, and 5) professional education. RESULTS Analysis (January 2010 to May 2018) of 7,798 patients from Tulane Medical Center (mean age 61 years, 57% female, 62% black, 97% insured) with 136,004 visits showed target improvements. A Cox proportional hazards model controlling for age, sex, race, and HbA1c level showed a statistically significant reduction in HbA1c undertesting >6 months (hazard ratio 1.20 ± 0.07). Statistical process control charts showed 15.5% relative improvement in the patient proportion with HbA1c >9% (75 mmol/mol) from 13% to 11% (P < 10–6) following QI interventions and a 2.1% improvement of population mean HbA1c from 7.4% (57 mmol/mol) to 7.2% (55 mmol/mol) (P < 10–6). CONCLUSIONS Multidisciplinary QI teams using EHR data to design interventions for providers and patients produced statistically significant improvements in both care process and clinical outcome goals. Full Article
are Late Relapse of Diabetes After Bariatric Surgery: Not Rare, but Not a Failure By care.diabetesjournals.org Published On :: 2020-02-20T11:55:29-08:00 OBJECTIVE To characterize the status of cardiometabolic risk factors after late relapse of type 2 diabetes mellitus (T2DM) and to identify factors predicting relapse after initial diabetes remission following bariatric surgery to construct prediction models for clinical practice. RESEARCH DESIGN AND METHODS Outcomes of 736 patients with T2DM who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) at an academic center (2004–2012) and had ≥5 years’ glycemic follow-up were assessed. Of 736 patients, 425 (58%) experienced diabetes remission (HbA1c <6.5% [48 mmol/mol] with patients off medications) in the 1st year after surgery. These 425 patients were followed for a median of 8 years (range 5–14) to characterize late relapse of diabetes. RESULTS In 136 (32%) patients who experienced late relapse, a statistically significant improvement in glycemic control, number of diabetes medications including insulin use, blood pressure, and lipid profile was still observed at long-term. Independent baseline predictors of late relapse were preoperative number of diabetes medications, duration of T2DM before surgery, and SG versus RYGB. Furthermore, patients who relapsed lost less weight during the 1st year after surgery and regained more weight afterward. Prediction models were constructed and externally validated. CONCLUSIONS While late relapse of T2DM is a real phenomenon (one-third of our cohort), it should not be considered a failure, as the trajectory of the disease and its related cardiometabolic risk factors is changed favorably after bariatric surgery. Earlier surgical intervention, RYGB (compared with SG) and more weight loss (less late weight regain) are associated with less diabetes relapse in the long-term. Full Article
are Who are our students? By blogs.ams.org Published On :: Mon, 03 Feb 2020 07:00:30 +0000 By: Edwin O’Shea, James Madison University In Marilynne Robinson’s Gilead, Reverend Ames testifies that each person in his flock has “a kind of incandescence in them… quick, and avid, and resourceful. To see this aspect of life is a privilege … Continue reading → Full Article Classroom Practices Faculty Experiences Student Experiences
are Square peg in an octagonal hole By blogs.ams.org Published On :: Tue, 14 Apr 2020 14:48:56 +0000 Interview with Ari Nieh, with commentary from Yvonne Lai Like many of us, I began teaching online this Spring. Unlike many of us, I began doing so at the start of the semester. I am co-teaching a class at Michigan … Continue reading → Full Article testing
are Diabetes in the Emergency Department: Acute Care of Diabetes Patients By clinical.diabetesjournals.org Published On :: 2011-04-01 Candace D. McNaughtonApr 1, 2011; 29:51-59Feature Articles Full Article
are Standards of Medical Care in Diabetes--2018 Abridged for Primary Care Providers By clinical.diabetesjournals.org Published On :: 2018-01-01 American Diabetes AssociationJan 1, 2018; 36:14-37Position Statements Full Article
are Standards of Medical Care in Diabetes--2019 Abridged for Primary Care Providers By clinical.diabetesjournals.org Published On :: 2019-01-01 American Diabetes AssociationJan 1, 2019; 37:11-34Position Statements Full Article
are Standards of Medical Care in Diabetes--2020 Abridged for Primary Care Providers By clinical.diabetesjournals.org Published On :: 2020-01-01 American Diabetes AssociationJan 1, 2020; 38:10-38Standards of Care Full Article
are Health Care Expenditures Among Adults With Diabetes After Oregons Medicaid Expansion By care.diabetesjournals.org Published On :: 2020-02-20T11:55:30-08:00 OBJECTIVE To compare trends in Medicaid expenditures among adults with diabetes who were newly eligible due to the Affordable Care Act (ACA) Medicaid expansion to trends among those previously eligible. RESEARCH DESIGN AND METHODS Using Oregon Medicaid administrative data from 1 January 2014 to 30 September 2016, a retrospective cohort study was conducted with propensity score–matched Medicaid eligibility groups (newly and previously eligible). Outcome measures included total per-member per-month (PMPM) Medicaid expenditures and PMPM expenditures in the following 12 categories: inpatient visits, emergency department visits, primary care physician visits, specialist visits, prescription drugs, transportation services, tests, imaging and echography, procedures, durable medical equipment, evaluation and management, and other or unknown services. RESULTS Total PMPM Medicaid expenditures for newly eligible enrollees with diabetes were initially considerably lower compared with PMPM expenditures for matched previously eligible enrollees during the first postexpansion quarter (mean values $561 vs. $793 PMPM, P = 0.018). Within the first three postexpansion quarters, PMPM expenditures of the newly eligible increased to a similar but slightly lower level. Afterward, PMPM expenditures of both groups continued to increase steadily. Most of the overall PMPM expenditure increase among the newly eligible was due to rapidly increasing prescription drug expenditures. CONCLUSIONS Newly eligible Medicaid enrollees with diabetes had slightly lower PMPM expenditures than previously eligible Medicaid enrollees. The increase in PMPM prescription drug expenditures suggests greater access to treatment over time. Full Article
are Redesigning Primary Care to Improve Diabetes Outcomes (the UNITED Study) By care.diabetesjournals.org Published On :: 2020-02-20T11:55:29-08:00 OBJECTIVE The effective redesign of primary care delivery systems to improve diabetes care requires an understanding of which particular components of delivery consistently lead to better clinical outcomes. We identified associations between common systems of care management (SysCMs) and the frequency of meeting standardized performance targets for Optimal Diabetes Care (NQF#0729) in primary care practices. RESEARCH DESIGN AND METHODS A validated survey of 585 eligible family or general internal medicine practices seeing ≥30 adult patients with diabetes in or near Minnesota during 2017 evaluated the presence of 62 SysCMs. From 419 (72%) practices completing the survey, NQF#0729 was determined in 396 (95%) from electronic health records, including 215,842 patients with type 1 or type 2 diabetes. RESULTS Three SysCMs were associated with higher rates of meeting performance targets across all practices: 1) a systematic process for shared decision making with patients (P = 0.001), 2) checklists of tests or interventions needed for prevention or monitoring of diabetes (P = 0.002), and 3) physician reminders of guideline-based age-appropriate risk assessments due at the patient visit (P = 0.002). When all three were in place, an additional 10.8% of the population achieved recommended performance measures. In subgroup analysis, 15 additional SysCMs were associated with better care in particular types of practices. CONCLUSIONS Diabetes care outcomes are better in primary care settings that use a patient-centered approach to systematically engage patients in decision making, remind physicians of age-appropriate risk assessments, and provide checklists for recommended diabetes interventions. Practice size and location are important considerations when redesigning delivery systems to improve performance. Full Article
are The Association Between Poor Glycemic Control and Health Care Costs in People With Diabetes: A Population-Based Study By care.diabetesjournals.org Published On :: 2020-03-20T11:50:34-07:00 OBJECTIVE To analyze the differences in health care costs according to glycemic control in people with type 2 diabetes. RESEARCH DESIGN AND METHODS Data on health care resource utilization from 100,391 people with type 2 diabetes were extracted from the electronic database used at the Catalan Health Institute. Multivariate regression models were carried out to test the impact of glycemic control (HbA1c) on total health care, hospital admission, and medication costs; model 1 adjusted for a variety of covariates, and model 2 also included micro- and macrovascular complications. Glycemic control was classified as good for HbA1c <7%, fair for ≥7% to <8%, poor for ≥8% to <10%, and very poor for ≥10%. RESULTS Mean per patient annual direct medical costs were 3,039 ± SD 6,581. Worse glycemic control was associated with higher total health care costs: compared with good glycemic control, health care costs increased by 18% (509.82) and 23% (661.35) in patients with very poor and poor glycemic control, respectively, when unadjusted and by 428.3 and 395.1, respectively, in model 2. Medication costs increased by 12% in patients with fair control and by 28% in those with very poor control (model 2). Patients with poor control had a higher probability of hospitalization than those with good control (5% in model 2) and a greater average cost when hospitalization occurred (811). CONCLUSIONS Poor glycemic control was directly related to higher total health care, hospitalization, and medication costs. Preventive strategies and good glycemic control in people with type 2 diabetes could reduce the economic impact associated with this disease. Full Article
are Impact of a Telephonic Intervention to Improve Diabetes Control on Health Care Utilization and Cost for Adults in South Bronx, New York By care.diabetesjournals.org Published On :: 2020-03-20T11:50:34-07:00 OBJECTIVE Self-management education and support are essential for improved diabetes control. A 1-year randomized telephonic diabetes self-management intervention (Bronx A1C) among a predominantly Latino and African American population in New York City was found effective in improving blood glucose control. To further those findings, this current study assessed the intervention’s impact in reducing health care utilization and costs over 4 years. RESEARCH DESIGN AND METHODS We measured inpatient (n = 816) health care utilization for Bronx A1C participants using an administrative data set containing all hospital discharges for New York State from 2006 to 2014. Multilevel mixed modeling was used to assess changes in health care utilization and costs between the telephonic diabetes intervention (Tele/Pr) arm and print-only (PrO) control arm. RESULTS During follow-up, excess relative reductions in all-cause hospitalizations for the Tele/Pr arm compared with PrO arm were statistically significant for odds of hospital use (odds ratio [OR] 0.89; 95% CI 0.82, 0.97; P < 0.01), number of hospital stays (rate ratio [RR] 0.90; 95% CI 0.81, 0.99; P = 0.04), and hospital costs (RR 0.90; 95% CI 0.84, 0.98; P = 0.01). Reductions in hospital use and costs were even stronger for diabetes-related hospitalizations. These outcomes were not significantly related to changes observed in hemoglobin A1c during individuals’ participation in the 1-year intervention. CONCLUSIONS These results indicate that the impact of the Bronx A1C intervention was not just on short-term improvements in glycemic control but also on long-term health care utilization. This finding is important because it suggests the benefits of the intervention were long-lasting with the potential to not only reduce hospitalizations but also to lower hospital-associated costs. Full Article
are Peacock protecting duck nest in patio area of Oregon bar By www.upi.com Published On :: Wed, 06 May 2020 15:00:37 -0400 Employees at an Oregon restaurant said a peacock has taken on the role of protector for a mother duck and the eggs she laid in the closed patio area. Full Article
are Colts QB Philip Rivers to coach at Alabama high school once NFL career ends By www.upi.com Published On :: Fri, 08 May 2020 21:04:31 -0400 Indianapolis Colts quarterback Philip Rivers will become the head football coach at St. Michael Catholic High School, the school announced Friday. Full Article
are Personalized Management of Hyperglycemia in Type 2 Diabetes: Reflections from a Diabetes Care Editors' Expert Forum By care.diabetesjournals.org Published On :: 2013-06-01 Itamar RazJun 1, 2013; 36:1779-1788Diabetes Care Expert Forum Full Article
are A Mathematical Model for the Determination of Total Area Under Glucose Tolerance and Other Metabolic Curves By care.diabetesjournals.org Published On :: 1994-02-01 Mary M TaiFeb 1, 1994; 17:152-154Short Report Full Article
are The Use of Areas Under Curves in Diabetes Research By care.diabetesjournals.org Published On :: 1995-02-01 David B AllisonFeb 1, 1995; 18:245-250Technical Article Full Article
are Cardiovascular Outcomes Trials in Type 2 Diabetes: Where Do We Go From Here? Reflections From a Diabetes Care Editors Expert Forum By care.diabetesjournals.org Published On :: 2018-01-01 William T. CefaluJan 1, 2018; 41:14-31Diabetes Care Expert Forum Full Article
